Abstract

MOAC0105 - Oral Abstract Session

An evolving concentrated epidemic: comparison of socioeconomic, behavioural and biological factors among newly diagnosed, previously diagnosed and HIV-negative black men who have sex with men in six US cities (HPTN 061)

1The Fenway Institute/Harvard Medical School, Boston, United States, 2Statistical Center for HIV/AIDS Research & Prevention (SCHARP), Seattle, United States, 3New York Blood Center, New York, United States, 4Harlem Hospital / Columbia University, Department of Medicine/Mailman School of Public Health, New York, United States, 5The George Washington University, Department of Epidemiology and Biostatistics, Washington, United States, 6Emory University Rollins School of Public Health, Department of Epidemiology, Atlanta, United States, 7San Francisco Department of Health, HIV Research Division, San Francisco, United States, 8Binghamton University, Department of Human Development, Binghamton, United States, 9Johns Hopkins University School of Medicine, Pathology Department, Baltimore, United States, 10FHI 360, Durham, United States, 11HPTN 061 Protocol Team, New York, United States

Background: Black
MSM (BMSM) constitute < 1% of the U.S. population, but >25% of incident
HIV infections. Enhanced understanding of factors associated with new
interventions can provide data to inform programs needed to address this
disproportionate epidemic.Methods: Between
7/09 and 10/10, BMSM were enrolled in 6 U.S. cities to evaluate feasibility of
a multi-component prevention intervention. This analysis focuses on the
correlates of being newly diagnosed with HIV, including multivariable
logistic regression. HIV testing was performed at study sites; central
confirmation of results is underway.Results: HPTN 061 enrolled 1553 BMSM, whose median age was 39; 43%
self-identified as gay/homosexual, 41% bisexual, 3% transgender, 10%
straight/heterosexual. Of 96% who agreed to be tested, 10% indicated they were
previously HIV-infected (PHIV), while 12% were newly diagnosed with HIV (NHIV).
Compared to PHIV, NHIV were younger less likely to use marijuana poppers stimulants
or inject drugs reported less internalized homophobia and lower levels of
religious affiliation NHIV were more likely to be diagnosed with syphilis and
anogenital gonorrhea/chlamydia than PHIV, and more likely to be diagnosed with
syphilis or anogenital chlamydia than HIV-uninfected BMSM. Compared to
HIV-uninfected BMSM, NHIV BMSM were more likely to be older unemployed engage
in unprotected anal intercourse have multiple bacterial STDs, and were more
likely to come from cities other than San Francisco.Conclusions: Structural,
behavioral, and biological factors (e.g. unemployment, unprotected anal sex, and STDs, but not increased substance use) are
associated with new infections among American BMSM, who differ behaviorally
from men who have previously been diagnosed. Given the high rates of HIV
infection among BMSM, culturally-tailored programs that encourage repeated
HIV/STD testing, engagement in care, and innovative prevention strategies
addressing current risks are urgently needed to decrease further spread.